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The Collection > Epidemiology of Errors and Adverse Events

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PATIENT SAFETY PRIMERS
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Adverse Events after Hospital Discharge

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Safety Target

•Device-related Complications (59)

•Diagnostic Errors (77)

•Identification Errors (53)

•Discontinuities, Gaps, and Hand-Off Problems (133)

•Fatigue and Sleep Deprivation (24)

•Medication Safety (472)

•Medical Complications (183)

•Nonsurgical Procedural Complications (21)

•Surgical Complications (231)

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•Australia and New Zealand (65)

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•Audiovisual (1)

•Book/Report (59)

•Clinical Guideline (1)

•Journal Article (1124)

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•Newspaper/Magazine Article (40)

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•Special or Theme Issue (3)

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Epidemiology of Errors and Adverse Events

Approach to Improving Safety

•Quality Improvement Strategies (250)

•Legal and Policy Approaches (69)

•Error Reporting and Analysis (523)

•Communication Improvement (227)

•Human Factors Engineering (120)

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•Technologic Approaches (206)

•Education and Training (157)

Clinical Areas

•Allied Health Services (5)

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•Medicine (1018)

•Nursing (74)

•Pharmacy (163)

Target Audience

•Health Care Providers (928)

•Health Care Executives and Administrators (1017)

•Non-Health Care Professionals (379)

•Patients (53)

Setting of Care

•Hospitals (993)

•Psychiatric Facilities (6)

•Residential Facilities (29)

•Ambulatory Care (123)

•Outpatient Surgery (22)

•Patient Transport (16)

1 - 20 of 1249

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STUDY

Association between Leapfrog safe practices score and hospital mortality in major surgery.

Qian F, Lustik SJ, Diachun CA, Wissler RN, Zollo RA, Glance LG. Med Care. 2011;49:1082-1088.

BOOK/REPORT

IBEAS: A Pioneer Study on Patient Safety in Latin America: Towards Safer Hospital Care.

Geneva, Switzerland: World Health Organization; 2011.

BOOK/REPORT

Patient Safety Authority Annual Reports.

Harrisburg, PA: Patient Safety Authority; April 2013.

STUDY

Sharing lessons learned to prevent incorrect surgery.

Neily J, Mills PD, Paull DE, et al. Am Surg. 2012;78:1276-1280.

REVIEW

Inpatient fall prevention programs as a patient safety strategy: a systematic review.

Miake-Lye IM, Hempel S, Ganz DA, Shekelle PG. Ann Intern Med. 2013;158(5 Pt 2):390-396.

BOOK/REPORT

Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2012.

Oakbrook Terrace, IL: The Joint Commission; September 2012.

COMMENTARY

Improving heparin safety: a multidisciplinary invited conference.

Peterson C, Ham CW, Vanderveen T. Hosp Pharm. 2008;43:491-497.

STUDY

Factors that influence the expected length of operation: results of a prospective study.

Gillespie BM, Chaboyer W, Fairweather N. BMJ Qual Saf. 2012;21:3-12.

STUDY

A multicenter, multidisciplinary, high-alert medication collaborative to improve patient safety: the Singapore experience.

Khoo AL, Teng M, Lim BP, Hons B, Tai HY, Lau TC. Jt Comm J Qual Patient Saf. 2013;39:205-212.

STUDY

Health care–associated invasive MRSA infections, 2005–2008.

Kallen AJ, Mu Y, Bulens S, et al; Active Bacterial Core surveillance (ABCs) MRSA Investigators of the Emerging Infections Program. JAMA. 2010;304:641-648.

STUDY

Communication failure in the operating room.

Halverson AL, Casey JT, Andersson J, et al. Surgery. 2011;49:305-310.

COMMENTARY

What Was in Those Platelets?

Yomtovian R. AHRQ WebM&M [serial online]. July 2008.

COMMENTARY

Miles to go: an introduction to the 5 Million Lives Campaign.

McCannon CJ, Hackbarth AD, Griffin FA. Jt Comm J Qual Patient Saf. 2007;33:477-484.

STUDY

French national survey of inpatient adverse events prospectively assessed with ward staff.

Michel P, Quenon JL, Djihoud A, Tricaud-Vialle S, de Sarasqueta AM. Qual Saf Health Care. 2007;16:369-377.

BOOK/REPORT classic

classic

Internal Bleeding: The Truth Behind America's Terrifying Epidemic of Medical Mistakes. Updated edition.

Wachter R, Shojania K. New York, NY: Rugged Land; 2005. ISBN: 1590710738.

STUDY

Influence of house-staff experience on teaching-hospital mortality: the "July Phenomenon" revisited.

van Walraven C, Jennings A, Wong J, Forster AJ. J Hosp Med. 2011;6:389-394.

STUDY

Effect of a "Lean" intervention to improve safety processes and outcomes on a surgical emergency unit.

McCulloch P, Kreckler S, New S, Sheena Y, Handa A, Catchpole K. BMJ. 2010;341:c5469.

STUDY

Variations in surgical outcomes associated with hospital compliance with safety practices.

Brooke BS, Dominici F, Pronovost PJ, Makary MA, Schneider E, Pawlik TM. Surgery. 2012;151:651-659.

NEWSPAPER/MAGAZINE ARTICLE

Beyond the count: preventing the retention of foreign objects.

PA-PSRS Patient Saf Advis. June 2009;6:39-45.

STUDY

The impact of medical errors on ninety-day costs and outcomes: an examination of surgical patients.

Encinosa WE, Hellinger FJ. Health Serv Res. 2008;43:2067-2085.

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